HomeMy WebLinkAboutApp-Permit-Compliance��— yo COMMONWEALTH Of MASSACHUSETTS
Board of Health, MA.
APPLICATION F®I, DISPOSAL SYSTEM CONSTRUCTION PERMI1
FEE 0, 00
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Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( 0 Complete System 0 Individual Components
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Location Lot 2 lfJt
Owner's Name
Habitat For Humanity
Map/Parcel# Map 36, Portions of lot 65 & 66
Address 411
Main Street, Yarmouth Port
Lot# 2
Telephone#
508-362-3559
Installer's Name Pi-Lh COM-TgAc vp—s, 1w,
Designer's Name
The BSC Group, Inc.
Address PA,$ox-77S D6-tJN6 D2%•
Address 349
Rt 28, West Yarmouth, MA
Telephone#
Telephone#
508-778-8919
Type of Building Residential
Dwelling - No. of Bedrooms
Other - Type of Building
Three (3
1. t Size 8, 4 7 2 sq. ft.
Garbage grinder None
No. of persons Showers ( ), Cafeteria ( )
Other Fixtures
Design Flow (min. required) 330 gpd Calculated design flow
Plan: Date 12-12-2014 Number of sheets 1
Title Septic System Design Plan, Lot 2, Virginia Street,
Design flow provided
Revision Date
West Yarmouth
343 gpd
Description ofSoil(s) See Plan
Soil Evaluator Form No. Name of Soil Evaluator Kieran Healy Date of Evaluation 10-8-14
DESCRIPTION OF REPAIRS OR ALTERATIONS
Install complete new septic system
The undersigned agrees to ir!Afl the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
furthert�lp
to pl to o hon until a Certificate of Compliance has been issued by the Board of Health.
Signed '� Date
Inspections
No. FEE�bO
COMMONWEALTH Of MASSACHUSETTS dk � 13`7 !
Board of Health,yi Otl-rtd AIA.
CERTIFICATE Of COMPLIANCE
Description of Work: ❑ Individual Component(s) ❑ Complete System
The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded ( ), Abandoned ( )
by: L.O 1 L- vy—> 1"t--
at
"t.at Lot 2, Virgina Street, West Yarmouth ¢ )sC
has been installed i acRdance th ClprcZisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
�, dated f J' / Approved Design Flow '�' (gpd)
application No. /
Installer _ i?�% l G� V-, M c-VOWe'LLA r 3
Designer: f4sC.- 612-0 op Inspector: 61 Date: I /
The issuance of this permit shall not be construed as a guaraee at the system will function as designed.
No. ti14 Vc-14-j-1vN-7 FEE 110.00
COMMONWEALTH Of MASSAC14USETIS -7q
Board of Health, yk-m0l9'S'1 , , MA.
DISPOSAL SYSTEM"CONSTRUCTION PERMIT
Permission is hereby granted to; ConstructX Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system
at Lot 2, Virgina Street, West Yarmouth �005P- 4#7E as described in the application for.
Disposal System Construction Permit No.)dated
�'� > > f
Provided: Construction shall be co l ted whin ks of the date of this permit. �All local conditions must be met.
Form 1255 Rev. 5/96 A.M. Sulkin Co. Chadeslown, MA Date4L L s- f 1 B rd of Health
No.: BOHDGIS-6147 _
Commonwealth of Massachusetts Fee
$710.00
Board of Health, Yarmouth, MA •
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to:New Construction-Complete System
Location: 7 VIRGINIA ST,WEST YARMOUTH, MA 02673 Owner:
HABITAT FOR HUMANITY OF CAPE COD INC
Map/Parcel#: 036.66.2 411 ROUTE 6A SUITE 6
YARMOUTH PORT,MA 02675
Phone:
Septic System Installer Designer
PKM CONTRACTORS, JM O'REILLY&ASSOCIATES INC.
P.O. BOX 175 EAST DENNIS, MA P.O.BOX 1773
02641 BREWSTER,MA 02631
Phone: 508-896-6601
5083855993
Type of Building:Dwelling Lot Size:7,841.00 Sq.Ft.
Dwelling-No.of Bedrooms:2 Garbage Grinder:
Other Type of Building: No.of persons: Showers:
Other Fixtures:
Plan Date: 12/21/2015 Number of Sheets: 1 Cafeteria:
Title:SITE&SEWAGE DISPOSAL SYSTEM DESIGN LOT 2(7E)VIRGINIA Revision Date:
STREET �
Design Flow(miarequired):220 gpd Calculated design flow:220 gpd Design flow provided:338 gpd
Description of Soi1s:SEE PLAN •
Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evaluation: 10/08/2014
KIERAN HEALY,P.L.S.
DESCRIPTION OF REPAIRS OR ALTERATIONS:SEPTIC DISPOSAL-NEW-PROPOSED 1500 GAL PLASTIC SEPTIC TANK,H-20
DBOX,3-500 GAL H-20 PRECAST CHAMBERS W/STONE:36'X 7.83'X 2'
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and further aarees not to olace in oueration until a Certificate of Comoliance has been issued bv the Board of Health.
Signed Date
Inspections
Commonwealth of Massachusetts �
Board of Health, Yarmouth, MA Fee
DISPOSAL SYSTEM CONSTRUCTION PERMIT $110.00 "
Permission is herby granted to;
PKM CONTRACTORS, INC., P.O. BOX 175, EAST DENNIS, MA 02641
To perform:New Construction an individual sewage disposal system.
Owner: HABITAT FOR HIJMANITY OF CAPE COD INC
4ll ROUTE 6A SUITE 6
YARMOUTH PORT,MA 02675
Location: 7E VIRGINIA ST,WEST YARMOUTH,MA 02673
Disposal System Construction Permit No.: BOHDC-15-6147,Dated:December 23,2015
Provided: Construction shall be completed within six months of the date of this permit. All local conditions must be met.
CONDITIONS:
1. SEPTIC DISPOSAL-NEW-PROPOSED 1500 GAL PLASTIC SEPTIC TANK, H-20 DBOX, 3-500 GAL H-20
PRECAST CHAMBERS W/STONE: 36'X 7.83'X 2'
2. BOH TO INSPECT SOIL REMOVAL
V
Bruce G. Mur y, H, R.S., CHO/Amy L.von Hone, R.S., CHO
ealth Director/Assistant Health Director
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.